血浆同型半胱氨酸和N-末端脑钠肽水平与急性冠脉综合征冠状动脉病变严重程度的相关性研究

摘要

目的 探讨血浆同型半胱氨酸(Hcy)及N-末端脑钠肽(NT-proBNP)水平与急性冠脉综合征(ACS)患者冠状动脉病变严重程度的相关性.方法 210例经冠状动脉造影证实的ACS患者根据Gensini评分系统对冠状动脉病变程度进行评分,并分为Gensini评分＜30分组和≥30分组;根据冠状动脉病变支数分为单支病变组、双支病变组和三支病变组,采用ELISA法及电化学发光法测定血浆Hcy、NT-proBNP水平,分析Hcy、NT-proBNP与冠状动脉Gensini积分及病变支数的相关性.结果 三支病变组及双支病变组Hcy及NT-proBNP均较单支病变组明显升高(P＜0.05);Gensini积分≥30分组患者血浆Hcy及NT-proBNP水平显著高于Gensini积分＜30分组(P＜0.05);Hcy水平与冠状动脉病变支数及Gensini积分呈正相关关系(r=0.68,0.72,P＜0.05),NT-proBNP水平与冠状动脉病变支数及Gensini积分亦呈正相关关系(r=0.77,0.83,P＜0.05).结论 ACS患者血浆Hcy及NT-proBNP水平与冠状动脉病变严重程度相关,二者随冠状动脉病变支数和病变严重程度的增加而逐渐升高.%Objectives To explore the correlation of plasma homocysteine ( Hey ) and N - terminal probrain natriuretic peptide ( NT - proBNP ) with severity of coronary lesions in patients with acute coronary syndrome ( ACS ). Methods A total of 210 ACS patients confirmed by coronary arteriongraphy were divided into groups <30 - score and ≥30 - score based on Gensini scores, and into groups 1 - diseased - vessel, 2 - diseased - vessel, 3 - diseased - vessel according to number of diseased vessels. The levels of Hey and NT - proBNP were determined by ELISA and electrochemiluminescence assay and correlations of Hey and NT - proBNP with Gensini scores and number of diseased vessels were analyzed. Results The Hey and NT - proBNP levels were higher in groups 2 - and 3 - diseased - vessel than in 1 - diseased - vessel group ( P < 0. 05 ), and higher in ≥ 30 - score group than in <30 - score group ( P <0. 05 ). Hey was positively correlated with number of diseased vessels and Gensini scores ( r = 0. 68, 0. 72, P < 0. 05 ), and NT - proBNP positively with number of diseased vessels and Gensini scores ( r = 0. 77, 0. 83, P < 0. 05 ). Conclusion Hey and NT - proBNP levels, correlated with severity of coronary lesions in ACS patients, gradually increase with the rise of number of diseased vessels and severity of coronary lesions.